The long-term outcome in acute, subacute, and chronic forms of pigeon breeder's disease hypersensitivity pneumonitis

Abstract

Background: Pigeon breeder's disease (PBD) is an avian-induced hypersensitivity pneumonitis. The limited data that exist on the long-term outcome for the disease are conflicting.

Objective: We sought to determine the long-term outcome of patients with PBD to evaluate the course of the disease.

Methods: Review a case series of 18 pigeon breeders that were followed from 4 to 26 years after initial diagnosis.

Results: Fourteen breeders reduced their bird contact significantly; four kept their birds. In eight patients with the acute form of the disease, pulmonary function either did not change from normal or improved to normal. Of five patients with subacute disease, four had persistent symptoms. All had mildly abnormal spirometry with either restrictive or obstructive changes which persisted. Five patients with chronic disease exhibited daily dyspnea. They had severe abnormalities of lung function at diagnosis. Of these patients, three improved and two deteriorated. Chest radiographs were of little value in predicting outcome.

Conclusions: Patients with the acute form of PBD have the best prognosis, compared with those with subacute and chronic forms. Although some improvement could be seen in most individuals, recovery may still not be complete. Those with the chronic form are at particular risk for morbidity.